Provider Demographics
NPI:1689054983
Name:KENDERIAN, VERA (DDS)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:
Last Name:KENDERIAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16701 VALLEY BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-6696
Mailing Address - Country:US
Mailing Address - Phone:909-356-4490
Mailing Address - Fax:
Practice Address - Street 1:2743 SUPERIOR DR NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-1773
Practice Address - Country:US
Practice Address - Phone:507-288-8060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64488122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist